caa a22 4500 606248307 CHVBK 20210128101349.0 cr unu---uuuuu 210128e20151201xx s 000 0 eng 10.1007/s12262-014-1034-5 doi (NATIONALLICENCE)springer-10.1007/s12262-014-1034-5 Acute Mesenteric Ischaemia— An Indian Perspective [Elektronische Daten] [Raghavendra Nagaraja, Prashantha Rao, Vinay Kumaran, Amitabh Yadav, Sorabh Kapoor, Vibha Varma, Naimish Mehta, Samiran Nundy] In Western countries, acute mesenteric ischaemia is commonly due to arterial occlusion and occurs in patients who are usually in their seventh decade. A venous cause for intestinal gangrene has been reported in only about 10%. We examined whether this was so in India and compared the clinical features of patients with mesenteric arterial and venous ischaemia and relate these to their ultimate prognosis. We studied retrospectively, the records of all patients admitted or referred to the department with a diagnosis of acute mesenteric ischaemia between January 1997 and October 2012, noting their demographic details and mode of presentation, the results of preoperative imaging and blood investigations, the extent of bowel ischaemia, and the length of bowel that was resected at operation and their outcome. There were 117 patients, 85 males and 32 females whose median age was 53years. Mesenteric venous thrombosis was seen in 56 patients (48%) and mesenteric arterial occlusion in 61 (52%). Forty six patients died (39%); 15 with venous occlusion (27%) and 31 with arterial occlusion (51%). Compared to patients with arterial occlusion, the patients with venous obstruction were younger, had a longer duration of symptoms, were less frequently hypotensive at presentation, had higher platelet counts, had a shorter length of bowel resected, had fewer colonic resections and had a lower mortality. Other predictors of mortality on multivariate analysis were a longer duration of symptoms, lower serum albumin and higher creatinine levels at presentation and a shorter length of residual bowel. In India, acute mesenteric ischaemia in tertiary care centres is due to venous thrombosis in almost half of the patients who are at least a decade younger than those in the West. Significant predictors of mortality include low serum albumin and raised creatinine levels, a shorter residual bowel length and an arterial cause for mesenteric ischaemia. Association of Surgeons of India, 2014 Mesenteric nationallicence Ischaemia nationallicence Gangrene nationallicence Thrombosis nationallicence Nagaraja Raghavendra Department of Surgical Gastroenterology and Liver Transplantation, Sir Ganga Ram Hospital, New Delhi, India aut Rao Prashantha Department of Surgical Gastroenterology and Liver Transplantation, Sir Ganga Ram Hospital, New Delhi, India aut Kumaran Vinay Department of Surgical Gastroenterology and Liver Transplantation, Sir Ganga Ram Hospital, New Delhi, India aut Yadav Amitabh Department of Surgical Gastroenterology and Liver Transplantation, Sir Ganga Ram Hospital, New Delhi, India aut Kapoor Sorabh Department of Surgical Gastroenterology and Liver Transplantation, Sir Ganga Ram Hospital, New Delhi, India aut Varma Vibha Department of Surgical Gastroenterology and Liver Transplantation, Sir Ganga Ram Hospital, New Delhi, India aut Mehta Naimish Department of Surgical Gastroenterology and Liver Transplantation, Sir Ganga Ram Hospital, New Delhi, India aut Nundy Samiran Department of Surgical Gastroenterology and Liver Transplantation, Sir Ganga Ram Hospital, New Delhi, India aut Indian Journal of Surgery Springer India 77(2015-12-01), 843-849 0972-2068 77<843 2015 77 12262 https://doi.org/10.1007/s12262-014-1034-5 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s12262-014-1034-5 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Nagaraja Raghavendra Department of Surgical Gastroenterology and Liver Transplantation, Sir Ganga Ram Hospital, New Delhi, India aut NATIONALLICENCE 700 1- Rao Prashantha Department of Surgical Gastroenterology and Liver Transplantation, Sir Ganga Ram Hospital, New Delhi, India aut NATIONALLICENCE 700 1- Kumaran Vinay Department of Surgical Gastroenterology and Liver Transplantation, Sir Ganga Ram Hospital, New Delhi, India aut NATIONALLICENCE 700 1- Yadav Amitabh Department of Surgical Gastroenterology and Liver Transplantation, Sir Ganga Ram Hospital, New Delhi, India aut NATIONALLICENCE 700 1- Kapoor Sorabh Department of Surgical Gastroenterology and Liver Transplantation, Sir Ganga Ram Hospital, New Delhi, India aut NATIONALLICENCE 700 1- Varma Vibha Department of Surgical Gastroenterology and Liver Transplantation, Sir Ganga Ram Hospital, New Delhi, India aut NATIONALLICENCE 700 1- Mehta Naimish Department of Surgical Gastroenterology and Liver Transplantation, Sir Ganga Ram Hospital, New Delhi, India aut NATIONALLICENCE 700 1- Nundy Samiran Department of Surgical Gastroenterology and Liver Transplantation, Sir Ganga Ram Hospital, New Delhi, India aut NATIONALLICENCE 773 0- Indian Journal of Surgery Springer India 77(2015-12-01), 843-849 0972-2068 77<843 2015 77 12262